27.1 Postanesthesia Recovery and Care

Perioperative refers to the entire surgical experience from preoperative to surgery to postoperative within the postanesthesia care unit (PACU). Postoperative refers to the time after surgery and includes the monitoring and interventions from the interdisciplinary team.
PACU duties include stabilizing the airway and monitoring vital signs.
Nurses must intervene to manage PONV for patient comfort by administering medications, maintaining proper fluid balance through intravenous therapy, and educating patients.
From the PACU, patients can be discharged to their home or transferred to another hospital unit.
Nurses use the ISBAR communication strategy when communicating about patients, especially during transitions of care.

27.2 Postoperative Pain Management

Pain is a subjective experience and not to be judged by the nurse’s interpretation of pain.
Pain management is a key task in the PACU, and nurses need to use a variety of tools to complete an effective pain assessment.
Pharmacological and nonpharmacological methods are available for nurses to manage postoperative pain.
Nurses educate patients about the relationship between pain management and the healing processes, encouraging adherence to prescribed medications and engagement in rehabilitation activities.

Transfer from the PACU to an inpatient unit such as an ICU, should focus on airway management and stabilization of vital signs.
ISBAR is the best practice standard for reporting or handing off from one health-care team member to another.
A key nursing activity for a postoperative patient is to differentiate between normal and abnormal physical findings.
Nursing duties beyond the PACU include activities to prevent complications and promote healing, such as providing hydration, nutrition, promoting mobility, and patient education.

Nursing care of the postoperative patient involves monitoring vital signs and surgical wound sites to quickly identify any complications.
Nursing care can help prevent many common complications, such as thromboembolic events (DVT and PE).
Nurses create a plan of care to prevent complications during the postoperative period.
By providing patient education, the nurse can support the patient and family’s psychosocial needs in the postoperative period. Collaborating with interdisciplinary team members helps strengthen the resources the patient has for best outcomes. Involving the family members and the patient’s support network in the postoperative care can be an emotional strength to a patient during recovery.